How to Fix the Cost Issue.... while increasing quality

Insuring Resources Commentary--

Yesterday at the Wisconsin State Capitol a leading expert on cost and quality issues in ehalth care gave a presentation to state lawmakers and others.

Here are some of the details:


Dartmouth Atlas Author Sees ACOs as Solution to Cost, Quality Concerns

Elliott Fisher, MD, Professor of Medicine at Dartmouth Medical School, presented his ideas on how Accountable Care Organizations (ACOs) could be promoted and implemented as a way to improve population health and lower costs. Fisher presented to a group of health care professionals and policymakers on February 25 in the State Capitol at a forum sponsored by the Evidence Based Health Policy Project. Fisher was a principal author of the Dartmouth Atlas that highlighted wide variations in national Medicare spending and utilization. The Atlas showed Wisconsin as having among the nation’s lowest Medicare costs, mainly due to more efficient provision of care.

The ACO model envisions provider organizations that can effectively manage the full continuum of care as real or virtually-integrated local delivery systems. This structure would be joined with targeted spending levels and health care performance measures to help achieve lower costs and better outcomes, with the providers sharing in any savings.

Fisher said while the ACO model is relatively new, it has shown promise in a number of settings. "Aligning financial and professional incentives, together with having better information that engages physicians and consumers, will enhance their ability to improve health and lower costs." He added that those areas of the country that have ACOs in place tend to have shared aims, physician engagement, use of data to drive change, and communities that are energized to make it happen.

Fisher recommends that policymakers promote the proliferation of the ACO model by legislation (as in enacting Medicare ACOs) or by easing regulatory barriers that complicate the formation of ACOs.